Orthopedic shoe



Nov. 27, 1928.

M. HILGERT ORTHOPEDIC sHoE Filed 'eb. 15, 1923 Patented Nov. 27, 1928.

PATENT OFFICE.

MATHEW HILGERT, orNEW YORK, N. Y.

ORTHOPEDIC SI'IOE.`

Application filed February 15, 1923. Serial No. 619,131.

This invention relates to boots and shoes and more particularly to orthopedic shoes, that is, shocs which, by their features of constructon, are designed to correct weakness and deformity of the lower limbs or feet from any cause. In my Patent No. 1,089,396. granted September'a, 1912, is disclosed a shoe construction by which I have been able to correct defects in locomotion due to an unbalanced muscula-r condition of the foot.

Gbjects of the present invention are not only to deal with and correct such abnormality but further to' enable persons su'lfer ing from iniirmities of the lower limb or limbs such as weakness, joint disease, atrophy, or partial paralysis, such, for example, as may result from the disease known rnfantile paralysis, to walk in a coinfortable and natural manner. I have found that the positions and movements of the hip and knee joints may be eontrolled by a shoe of special construction, so that persons uiiable to walk at all or only by the aid of crutches or other auxiliary support are enabled not only to walk in a natural manner, but also to have the circulat-ion and congestedr conditions of the limbs so improved that natural c-ure of the infirmity is greatlv accelerated. This result is brought about by restoring to normal balance the entire muscular organization of the foot. and then so supporting the foot and con trolling the tibia and fibula. above the anlrle and through them the femur that, when the weight of the body begins to bear on the foot, the knee and hip jointswill be controlled and thrown into their natural and proper positions to support the weight of the body.

In developing the structure of the shoe by whicl'i these results are obtained, I 'first consider the requirement of the individual whose locomotion is to be corrected and if, as is usually the case, the foot muscles are out of balance, I provide inside the shoe a filler made prcferably in accordance with my pat-- cat abore ment-ioned to secure the proper balance of the foot muscles, and then incorporate in the shoe means for transmitting' the foot pressure to the leg bones. to cause bending` of the knee and hip oints in a natural manner. Such means may comprise either means for controlling' the movement of the leg' bones and joints laterally of the foot or means for controlling the movement of the leg bones and joints longitudinally of the foot, or both, as indivdual requirements may dictate. For controllingr the longitudinal movements I employ a counter and counter extension of special construction to be explaned later in detail, and for controlling the lateral mo-vements I provide. a tongue and stiffener of special construction which will be fully explained.

For controlling the longitudinal movement of the leg bones and joint-s I provide, as shown, a st-iffener at the inner side of the foot which preferably is formed by an extension of a Stiff counter 'of sole leather or other suitable material, and in cases where greater rigidity of the extension lengthwise of the foo-t is required and to prevent bending or buclrling` of the counter extension in that direct-ion, a resilient member of whalebone or steel is firmly secured to the counter extension on its outer side. The extension and resilient member extend above the ankle oint and are secured to the'leg of the shoe so that when the shoe is lalced a firm connection etween the foot and the principal leg bone or tibia is estab-lished through the extension, its stiffener and the cormter, and by this connection the position of these bones longitudinally relatively to the foot is determined.

The special construction by which the control of the position of the leg bones laterally of the foot is effected may as shown, comprise a tongue which is wide as compared with the usual shoe tongue, is shaped to the transverse and longitudinal curvesl of the front surfaces of the tibia and instep, and is stiffened against bending laterally of the foot. Then such a tongue is clamped to the front surface of the tibia and to the outer surfaces of the scapho-id, cuneiform, and'ot-her tars'al bones forming the instep', by the shoe lacing, the tongue, by reason of its inherent stifness laterally of the foot, establishes a-firm relation between the foot and tibiia so that the position of the tibia, and hence of the knee and hip oints, is controllcd bythe foot. Thus, if the knee tends to bend inwardly, the pressure of the balanced sole on the ground acts through the stiffened tongue to throw it outwardly, and conversely, ifl the 'knee tends to swing outwardly, it is thrown inwardly to its normal position. v

. In certain hip joint diseases, Where luxation occurs unless the patient contorts the limb and Walks lame, I have been able, by providing a shoe made in accordance With this in- Vention as above Vexplained, to control the femur and maintain its head in the cupshaped cavity of the aoetabulum, thus enabling thevpatient to walk in a natural manner.

In certain cases, especially where the conditions are such that the patient has a tendden-cy to drag either or both toes when attempting to walk, a resilient member is provided between. the inner and outer sole-s eX- tending substantially to the toe. By properly shaping this member, and relating` it to the counter extension, the foot may be held by the shoe in such a' position that the toe will clear the ground without dragging.` lVhen the weight of the body is brought down on the foot the resilient member yields and allows the sole to assume its normal foot supporting position.

To render' the shoe comfortable and easy to the foot, suitable padding such as soft felt is suitably located. Such padding` may, in thickness and location, take into consideration the form and peculiarities of the individual foot and correct foot abnormalities such as low instep.

Shoes of this kind will find a wide use not only in relieving conditions due to Wealrness and deformity of the lower limbs but also in cases where, for any reason, unusual support and protection for the 'ankle are necessary or desirable.

Other objects of the inventon are to provide a novel construction offtongue or stiffener, and a novel constructionV of combined counter and ankle brace.

These and otherobjects of the invention will appear more fully from the follovv'ing;` detailed descripton when read in connection with the accompanying drawing` and will be point-ed out in the append-ed claims.

he novel construction of the shoe tongue herein shown and described but not claimed per se is being claimed in a. divisional application Serial No. 285,198 filed November 23rd, 1927.

In the drawings,

Fig. 1 is a side view of my complete shoe, parts being` broken away and in section;

v Fig. 2 is a perspe'ctive detail of the counter and ankle stiffener;

Fig. 3 is a plan view, partly in section on the line 3-3 of Fig. 2, of the construction shown in Fig. 2;

Fig. 4 is a section on the line 11;-4 of Fig. 1;

,Figz 5 is a view showing in perspective and transverse section the toe portion of the vshoe and Fig. 6 is a Perspective view of the bottom of the sho-e with the heel and outsole removed.

The shoe may be, in general, of the usual welt shoe or other construction, the present invention being embodied in special construction which may be employed irrespectively of the type of shoe.

The counter of the shoe, including the anlrle brace or stifener, 1s shown separately in Fig'. 2. The counter proper preferably is made in two parts 2, 4 which are secured together by a back seam 6. The counter is preferably made of sole leather and hence substantial economy is efi'ected by makingit in two pieces, since Smaller pieces of leather may be used. The counter is preferably molded to fit the ball of the heel. On the inner side'of the shoe the counter is formed with an integral upward extension 8 which reaches nearly to the top of the leg portion of a high shoe. Outside of the upper portion of the extension 8 is a strip 10 preferably of tempered steel which is riveted at 12, 14 to the extension 8 With its widthwise dimension extending lengthwise of the shoe. V At its lower end the steel piece 10 passes through a slit 16 in the counter to its inner side and has its lower end firmly secured to the counter Al, for example, by a rivet 18. The resilient-strip 10 may yield to lateral flexure of the ankle joint but is substantially rigid against bending in a plane extending' longitudinally of the foot. Outside of'the steel piece 10 is a covering' 20 of thin leather to protect the upper of the shoe, the covering` being sewed by a seam 22 to the counter and counter extension 8. The counter and ankle stiffener, asseinbled as described, are incorporated into the shoe construction between the upper 241- and lining 26, the inner face of the counter' and extension being, if desired, padded with felt to insure comfort to the wearer. After the counter has been built into the shoe the upper end of the extension is sewed to the upper and lining by a seam 28 to anchor the extension and stiffener securely to the leg` of the shoe and render iteffective to control bendinfr of the leg` of the patient longitudinally of the foot.

rllhe novel construction of the tongue with which the shoe is provided is as follows: The tongue consists of an outer layer of upper leather and an inner layer 82 of fabric such as canvas or' the like. These layers extend beneath the vainp at the throat of the shoe and are secured to the upper by the vamp scam. The layers 30, are preferably V sewed together by a seain about their peripherics to form a pocket or enclosure for the stiifening members located between them.

These members comprise a wide stiff piece 36 of n'iaterial, for example sole leather skived to a thin edge at each side and at its lower end, and a tempered stecl strip 38 arranged outside the leather piece and secured to it by rivets 4-0, the Widthwise dimension of the strip extending transversely of the shoe and substantially at right angle's to the plane of the counter stifi'ener, strip 10. The layers 30, 32 of the tongue and the piece 30 are wide as compared to the usual shoe tongue and are shaped to conform lateralll'v' to the front arch of the leg and instep, that is, to the shape of the front surfaces of the tibia, scaphoid, cuneiforin and Other tarsal bones, so as iirmly to grip thenji when the shoe laced up. rl`his construction renders the lateral st-ii'ness of the resilient strip 38 effective to control the position of the bones of the leg by stiifening' the anlile joint laterally of the foot. On the inner side of the. sole leather piece 86 is a thicl; pad of felt the thiclness of which may be raried to suit different foot requirements and to vary the a-pparent height of the instep. On the inner side of the layer 30 is a thin. pad of felt 44: to protect it from the steel picce 38 and rivets 40. In the construction described the tongue and counter stifeners cooperate to afl'ord adequate lateral and longitudinal control of the bones of the leg` through the anlrle joint in a very eifective manner.

In order to secure the desired control Lof the leg` bones through the count and tongue construction above described, it is important that any unbalanced niuscular eondition of the foot be corrected and for this purpose i prefe-r to incorporatke. in the present construction, a filler made in accordance with my patent above mentioned-and by the method disclosed in my Patent No. LOIQ'YQ, granted July 16, 1912. The filler, as shown at 60 in Fig. 5, consists'of a false inner-sole which is thickened on one side or the other, depending; upon the muscular condition of the foot for which it is intended, to support one side of the foot and relieve labnormal strain upon the ligaments of the foot. The upper or inner face of the filler 60 is preferably contoured to fit the bottom of the foot and the lower or outer face is shaped to lit the inside tread of the shoe. and the thickness of the filler is Varied transversely to overcome any tendency ofthe foot to r0ll transyersely to one side or the other.

The filler 60 is applied to the last 'over which the shoe is made so that the. normal appearance and size of the shoe are not affected and, when prop'erly designed with reference to the particular conditions found in an indiyidual foot, tends torestore to normal balance the entire muscularv organization of the foot. The shoe is provideth shown, with the usual bottom filler (32 applied to the outer face of the innersole 03 and with an outersole 64: attached by a welt 66 in the usual manner.

By means of the iiller 60 and the construction of the tongue and counter above described. I ain ay` iie, by restoring` the norinal lnilanoe of the foot and counteracting any tendency of the foot to roll. to control the action of the leaq bones and the knee and hip `ioints so that persons afiiicted with disease or malforination of these bones or joints, or having` wealrness or paralysis of the leg' muscles, are enabled to walk with ease in'a sul stantially natural manner.

i/Vhen the pressure of the foot and shoe in walking is brought to bear on a tread surface, the proper balanced pressure of the foot is effected by the filler and. this pressure is then transmitted through the stifened ankle `ioint to the leg; bones, causing the leg` at the knee and hip oints to bend in its proper and natural manner. Of course, when the balance of the foot is norinal and no correction is re- (piired`l the filler may be made uniform in thiclrness or oi'nitted.` in which case the novel construction of the counter and tongue will act to transinit the foot pressure to the leg' bones and control their movement.

In some cases of defcctive locomotion, for instance where there is a tendency for the toe to drag upon the ground, i desirable to control the position. of the frepart of the foot relatively to the rear part. For this purpose a sole stiifcner is provided which controls the contour vof the soe in a Vertical plane and in the instance noted is bentupwardly at its forward end to lift the toe of the shoe and prevent drag'ging of the toe as the leg is swung forward in taking a step. As shown in Fig. 6, a usual shank stiffener 50 has secured thereto, or formed integrally thereuf'ith, a resilient prolongation 59 which extends substantially to the 'toe of the sole and is preferably secured to the innersole hy a thread 54 extending` repeatedly across the prolongation 52 and into the substance of the innersole at 56 on each side of the prolongation 52. Preferably the extremeV forward end of the prolongation is inserted Vat 58 in a slit formed in the substance of the the shoe and foot may be controlled when noy v weight is borne upon the foot. Thus, by giving the resilient' prolongation an initial set which will normally raise the toe of the shoe and foot when pressure of the foot on the ground is relieved, the leg and foot may be iswung forwardly and any tendency of the toe to drag on the ground prevented. The resilient prolongation will yield when the foot is pressed upon the ground to allow the foot and shoe to assume their no'rnial body sumaorting` position.

Having thus described my invention, what I claim as new and desire to secure by Letters Patent of the Unit-ed States is:

1. In an orthopedic shoe, a solo portion thicl-:er on oneside than the other to control. the position of the foot about its longitudinal axis when pressed upon the ground, and a shoe upper stiffened against bendinfz; at the ankle longitudinally and transversely of the shoe whereby the position of the foot upon the ground determines by pressure transmitted beyond the anlrle `ioint the position of the leg` bones and assists them to support the body in case inuscular control is weak.

2. An orthopedic shoe having` its sole portioii thickened locally at oiie side of the foot to balance or 'correct abnormal or unequal pressure of the foot at opposite sides thereof, and an upper stiifener ncorporated tlierein to stiffen the ankle joint transversely of the foot and thus ren'der the foot pressure effective beyond the ankle joint to control the leg bones and supplement defective muscular control thereof.

3. Iii an ortliopedic shoe, ineans for directing the transverse roll of the foot, and means for stiifening the ankle joint transversely of tlie foot to cause said roll, due to pressure of the foot upon the tread surface, to be transmitted to the leg bones to effect flexing of the knee joint when muscular control is defective.

4. An orthopedic shoe having its sole portion tliickened locally to 'balance or correct abnormal or unequal foot pressure, an upper and counter stiffener constructed and arranged to stiifen the ankle against bendiiig longitudinally of-the foot, and a. tongue Stiffener construct-ed and arranged to stift'en the ankle against transverse bending, said stiffeners acting to dispose the leg bones in predeterniined relation to the walking plane as a result of foot pressure thereon.

5. In an orthopedic shoe, means for throwing the foot pressure to one side of the foot, and a shoe tongue stiifened against transverse bending at the ankle to cause pressure of the foot upon the ground to be transmitted to the leg bones and to throw the knee joint away from the side on which the pressure is greater. 1

6. In a high shoe, the combination of a counter having an upward extension stitfened against bending longitudinally of the foot, and a tongue stifiened against bending 'transversely of the foot, said tongue being shaped to the transverse ourve of the ankle` and instep and adapted to be held thereaga-inst by the upper closing means.

a L I 7 li shoe having a tongue stiffener and a counter stiffener each eoniprising a leather piece and a thin resilient member secured thereto, the resilient inembers being disposed witli their widthwise dimensions in different planes to nnpart stitfness to the ankle joint laterall f and loneitudinall of the foot.

ob s q 1 8. A shoe having, in combinat-ion, a stiffieasoe ened tongue. and a st-iffened counter, the tongue stifli'en-er comprising a piece of heavy leatlier and a strip of stee-l sec'ured together and the counter stiifener comprising an integral upwar'd extension on the counter and a steel stiffener secured to the extension and to the counter, thestrips being disposed. in different planes to aford support to the ankle joint laterally and longitudinally of the foot.

9. In a shoe, the combination of a` counter having an upward extension upon the inner side of the foot to form an ankle stay, a nietallie element seeured to said extension and counter to a-ford stiifness against bending of the ankle longitudinally of the foot, aI wide tongue fitting the transve-rse curve of the ankle and instep, and a flat inetallic element secured to the tongue and disposed at right angles to the plane of the counter element to stiffen the tongue against lateral bending of the foot.

10. AV shoe having a tongue stiffener and an ankle stiffener, eacli comprising a leatlier base and a thin resilient member secured thereto. p

11. An orthopedic shoe having its sole portion thickened locally to balance and correct ahnormal or unequal foot pressure, an upper and counter stiffener eonstruct-ed and arranged to stfen the ankle against bending longitudinally of the foot, and a resilient sole stiffener prolonged substantially to the toe and contoured to hold the toe portion of the shoe flexed upward to prevent dragging of the toe upon the ground.

12. In an orthopedie slioe, means` for throwng the foot pressure to one side of the foot, a shoe tongue stiifened against transverse bending at the ankle, and a shank stiffener having a. prolonga-tion extending substantially to the toe of the shoe, said prolongation being resilient and noriually bent upwardly to hold the toe of the: shoe raised wlien the foot is off the ground and capable of bending to allow the shoe to resume its norinal shape when pressed by the wearer on the ground.

`In testiniony where-of I have sgned my name to this speeifieation,

MATHEIV HILGER'I 

